Objectives: To report the results of the 2011 National Oral Health Survey which was conducted to assess the dental caries, sequelae, and selected risk indicators in the population.
Methods: A sample of 2028 participants aged 6, 12-13, 15-17 and 35-44 was recruited from Phnom Penh and four provinces to represent age, sex, and urban/rural locations. Examinations were conducted using ambient light and mouth mirrors by standardized examiners. Tooth-specific data were obtained to calculate the number of decayed, missing and filled teeth (dmft) and number of teeth with pulp, ulcer, fistula, and abscess sequelae (PUFA index). Interviews were carried out to collect socio-demographic and behavioral information. T and ƒÔ2 tests were used to assess statistical differences (ƒ¿ < 0.05).
Results: The prevalence of dental caries was 93% at age 6 years, and 80% at age 12-13, and 35-44 years. At age 6 years, the mean dmft was 9.0 (standard deviation [SD] 4.9) and the mean PUFA 2.7 (SD 2.8); at age 12-13 years the mean DMFT was 3.8 (SD 3.6) and the mean PUFA 0.9 (SD 1.6); at age 35-44 years the mean DMFT was 5.6 (SD
5.8) and the mean PUFA 1.9 (SD 3.1). There was a high frequency of cariogenic foods consumption by children and adolescents, and prolonged nocturnal breastfeeding was common. Around 62% of children aged 6 years had not started tooth brushing yet.
Conclusion: The Cambodian population experiences a high burden of dental caries requiring immediate public health interventions.

Background: The objective of this study was to investigate the relationship between patient perceptions and professional assessments for restorative treatment needs in the population attending dental clinics at Hail.
Materials and Methods: This is a descriptive study with a crosssectional design. A validated questionnaire encompassing five subject areas for the dentists and patients was used as a study tool for
this study. Data were presented in form of numbers. Chi‑square test was employed to identify association among patient and dentists. P < 0.05 was considered significant.
Results: About 26% patients perceived discoloration compared to 41% reported by dentist, 70% patients and 59% dentist reported it not being a problem. Seventy-two (72%) patients perceived pain as a
concern compared to 91% by dentists. Both findings were statistically significant P < 0.05. Twenty Eight (28%) patients perceived space as a concern compared to 32% by the dentist. Whereas for 70%
patients space was not a concern, compared to 68% by the dentists. Similarly, for loose teeth 53% patients and 47% dentists perceived it as a concern, whereas 47% patients and 53% dentists did not. Both findings were not statistically significant at P > 0.05.
Conclusions: A significant difference was observed between patient and dentist perception of pain and esthetics (poor color). This difference could be because of esthetics and pain being subjective entities. The cost was not a barrier in seeking dental consultation.

Background: Methods based on metabolic activity and cell viability, such as XTT reduction assay and counting colony-forming units (CFU), have been frequently used for biofilm evaluation.
The association between the metabolic activities experiments with counting CFU is labor-intensive that need to be done separately. Thus, the aim of this study was to evaluate the effects of XTT salt, and other compounds used to XTT reduction assay on the cell viability of Candida albicans and Streptococcus mutans biofilms.
Material and Methods:C. albicans or S. mutans was formed on a microtiter plate. After 48 h, the mature biofilm, to evaluate the effect of these different compounds of XTT on cell viability, the biofilms were divided into five experimental groups (n = 5). The plates were incubated for 3 h in dark conditions at 37°C. The cell viability was evaluated by counting the number CFU mL−1.
Results: The results obtained for C. albicans and S. mutans showed differences between the incubation solutions for both microorganisms, however, the differences remained >106 CFU mL1.
Conclusion: These findings indicate that the XTT salt and the compounds used for the XTT reduction assay did not exhibit any effect on cell viability of the microorganisms tested.

Background: The purpose of this study was an evaluation of the effect of contact with moisture on the location and area of gaps or voids in the sealer during canal obturation with lateral condensation
method.
Materials and Methods: 60 extracted human teeth were selected. The teeth were divided into 4 groups: In groups, one and two after cleaning and shaping the canals were dried with paper cones, then were
filled with gutta-percha and AH26 sealer (in group one) and Rosen sealer (in group two) using lateral condensation method. In groups, three and four canals were not dried and were filled with gutta-percha
and AH26 sealer (in group three) and Rosen sealer (in group four). Each root was sliced to three coronal, middle, and apical sections. Using a stereomicroscope with ×40 zoom, digital images of the coronal side of each section were prepared. The surface area of gaps or voids was measured using ArchiCad software in square micrometers unit. The data were analyzed using Kruskal– Wallis and Mann– Whitney tests using SPSS software version 19 at a significant level of 0.05.
Results: The results demonstrated that there was no significant difference between four groups of study in relation to surface area and percentage of gaps or voids in three sections (P > 0.05).
Conclusion: Based on the result of this study type of sealer and condition of the canal have not a significant impact on the formation of void following canal obturation.

Validation of Arabic Version of the Modified Dental Anxiety Scale and Assessment of Cut-off Points for High Dental Anxiety in a Saudi Population

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Lubna Al-Nasser, Faisel Yunus, Anwar Ahmed

Background: Dental anxiety is a common problem faced by the patients and dental health professionals globally. High levels of anxiety in anticipation of encounters in a dental setting have been linked to a myriad of dental problems such as appointment avoidance and increased chair time. To validate the Arabic version of the modified dental anxiety scale (MDAS) and assess cut‑off points for a high dental anxiety in a Saudi population.
Materials and Methods: We conducted a cross‑sectional survey at the King Abdulaziz Medical City in Riyadh, Saudi Arabia in December 2012. The survey included randomly chosen Saudi
patients aged 18 or above, who attended dental or family medicine clinics during the survey phase.
Results: A total of 24 (37.5%) respondents had missed or cancelled dental appointments due to dental anxiety. The internal consistency of MDAS subscales was high with Cronbach's alpha = 0.90. The factor analysis suggested a single dimension solution accounting for 71.7% of the variance.The cut‑off point of 13 had the highest combination of the sensitivity, specificity and the largest area under the curve compared to cut‑off points of 16 and 19 in our study population. Respondents with a history of missed appointments (due to anxiety) scored significantly higher on the MDAS than those who had no history of missed appointments (14.5 ± 5.6 vs. 10.1 ± 4.0, P = 0.001).
Conclusion: The Arabic MDAS showed high reliability and validity, supporting its use in further studies among Arabic‑speakers. A cut‑off point of 13 can be used to identify patients who are more
likely to exhibit non‑attendance behavior.

Background: To evaluate the level of oral health knowledge and practice among Saudi schoolteachers in Al‑Kharj, and to assess their attitudes toward the utilization of schoolteachers' services in oral health promotion.
Materials and Methods: This cross‑sectional study used a questionnaire comprising three sections and 18 different items that assessed teachers' oral health knowledge (6 items), practice (6 items),
and attitudes (6 items). Mean section scores were calculated and a score of ≥ 3 was considered acceptable/positive. Non‑parametric tests were used to compare the mean scores on each section among different age groups, genders, and educational levels.
Results: A total of 1258 completed questionnaires were returned with a response rate of 78.7%. From a score of 6, schoolteachers' means scores were 3.01 for knowledge, 3.39 for practice, and 1.69 for attitudes. Older teachers, female teachers, and teachers with education below university level had better oral health knowledge, superior practice, and healthier attitudes toward oral health promotion in schools (P < 0.05).
Conclusion: Saudi public school teachers in Al‑Kharj had basic oral health knowledge and relatively acceptable practices; however, they had negative attitudes toward promoting oral health in schools.

Background: Information about microstrain changes in human root dentine after application of chelating agent still limited. This result needed to determine the factors of microstrain which caused by non‑instrumentation of human root dentine formation.
Materials and Methods: This experimental conducted in Department of Physic ‑ Faculty of Nature and Mathematics Science, Syiah Kuala University. All 45 specimens randomly divided base on experiment solutions. All specimens were immersed for 15 min than powdered for X‑ray diffraction (XRD) analysis. Grain size calculated using Scherer equation and microstrain using Hall‑Plot.
Result: XRD patterns typically show apatitic and amorf crystallized. A crystal phase of ethylene diamine tetra acetic acid (EDTA) group known as CaOH, RcPrep group as fluorapatite, and Control as Ca‑Cl, XRD pattern of EDTA confirmed as larger crystal than both control and RcPrep group. XRD pattern of RcPrep group confirmed as larger crystal than the control group. The average value of grain
size indicates all treatment groups have larger grain size than control. Microstrain of the control group showed as a lower value than all treatment groups. Microstrain of EDTA group showed as the
biggest value than RcPrep and control. Microstrain of EDTA and RcPrep indicate larger than control. Regression analysis of between control and both treatment groups were significant (P < 0.05). Microstrain of EDTA significantly greater than RcPrep. The relationships between EDTA to Control is weak (R2 = 0.37) same as relationship of control and RcPrep (R2 = 0.37).
Conclusion: Chelating agent application into root canal is either change structure or improving microstrain of apatite crystal. Concentration and exposure time of chelating agent may lead as the main factor increasing fracture risk of human root dentine. Application of RcPrep into human root dentine is better than EDTA in relation to decreasing of dentin fracture. EDTA has more capability to increase of microstrain of apatite crystal than RcPrep.

Background: This study evaluated bacterial decontamination on nitriding-treated (etched with nitric acid) (TiT) and non-treated titanium (TiNT) machined discs using photodynamic therapy (PDT). An implant's surface roughness has a significant impact on bacterial plaque accumulation, as rough surfaces encourage
biofilm formation. The surfaces of treated titanium implants tend to be a more asperous. Initial bacterial adhesion begins in areas of surface free of energy and wettability and inside the grooves of the roughened surfaces, from where it is difficult to eliminate plaque.The aim of this in vitro study was to evaluate two PDT protocols on both treated and TiNT surfaces, contaminated with Staphylococcus aureus or Escherichia coli.
Materials and Methods: Low-level laser (LLL) and methylene blue or light emitting diode (LED) and curcumin were used to decontaminate 60 machined titanium discs. ANOVA and Tukey's multiple comparison tests were applied.
Results: Our results showed that PDT reduced the number of bacteria on titanium discs, regardless of surface treatment (TiT and TiNT) (P < 0.05). There was no statistically significant difference between the tested groups (LLL and LED).
Conclusion: Based on these results, PDT could be considered an additional treatment option. Furthermore, in vitro and prospective clinical trials are necessary for confirmation of these results.

Background: Knowledge about the anatomical landmarks is essential for a clinician to provide the better treatment. By various studies, it is well-documented that position of mental foramen (MF) varies among different types of ethnic groups. This study was done to determine the position of the MF in relation to the apices of the teeth using panoramic radiographs in Indian and Iranian population. We also analyzed the symmetry of location of the MF within each individual.
Materials and Methods: A total of 40 panoramic radiographs (20 Indians and 20 Iranians) were analyzed with regard to the location and symmetry of the mental foramina in male and female subjects. Statistical analysis used: The results were analyzed using Chi-square test.
Results: The MF was situated below the apex of the second premolar in 52.5% of Indians, 47.5% of Iranians. 45% of it was between the first and second premolars among Indians and 47.5% of Iranians. It was symmetrically located in 70% of Indians and 60% of Iranians. There was no statistically significant difference was found between males and females in the position and symmetry of the MF.
Conclusions: The most common position of MF was below the second premolar and between the apices of the first and second premolar. MF is not always symmetrical in the same individual. From the study, we can suggest that the location of the MF is not a reliable landmark for distinguishing race but it is further necessary to do a study by considering larger sample size.

Background: Simonart's bands are confined to the soft tissue adhesions between medial and lateral margins of the cleft in the lip, nostril, or between the divided alveolar processes. A cephalometric analysis was carried out to see if Simonart's bands at birth are associated with craniofacial growth.
Materials and Methods: Mixed longitudinal data from 5 years through 18 years was evaluated for 260 individuals with complete unilateral cleft lip and palate (UCLP) in Sri Sri Bordha Hospital, 90 with Simonart's bands, and 170 without. A cephalometric analysis was carried out to the significant relationship with facial
growth.
Results: No major differences were detected between individuals with or without Simonart's bands though the presence of these bands was associated with a larger cranial base angle and slightly more favorable maxillomandibular relationship. The findings are drawn based on embryogenesis, primary surgery, and secondary surgery.
Conclusion: The cephalometric terms for patients' with Simonart's bands in UCLP patients have a negligible impact on facial growth.

Background: The purpose of the study was to evaluate leaching properties of the colored elastomeric modules when exposed to various dietary media.
Materials and Methods: Sample size was of 160 color modules (red, blue, green, black, 40 each) which were taken to evaluate the leaching properties by immersing in four dietary media (artificial saliva, artificial saliva with coke, artificial saliva with turmeric, and artificial saliva with coffee). After placing the segment of module strip in the beakers containing different dietary media, all the beakers were kept in the incubator at 37°C for 72 h. After 72 h of incubation, all the segment of module strips was removed
from the dietary media. Solutions were checked for the leaching of the die from the modules. Fiber optic spectrophotometer was used to check the quantum of color leached from the color elastomeric module.
Results: Statistical results were obtained using ANOVA and t‑test in SPSS Software. According to the results obtained, all the four colored modules had significantly leached out in various quantities when it was exposed to dietary media. Black and blue leached more while green leached less in the all the dietary media.
Conclusion: The purpose of the study was to identify the materials which were least vulnerable to changes when exposed to different media. Green color module leached the least than other color module in the dietary medium with blue and black leaching more.

Metastases to Level IIB in Oral Cavity Cancers: Is there a Possibility of Super Selective Neck Dissection?

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S Elengkumaran, C Puneet, KS Sabitha

Background: One of the common problems associated with supraomohyoid neck dissection (SOHND) is shoulder syndrome due to spinal accessory nerve (SAN) dysfunction. This prospective
study investigated the incidence of cervical node metastasis in sublevel IIB lymph nodes to determine the oncologic safety of preserving these nodes during SOHND for oral cavity cancers (other than cancer tongue) with clinically negative neck (cN0), thus avoiding associated morbidity related to SAN dysfunction.
Materials and Methods: A total of 101 oral cancer patients (other than cancer tongue) with cN0 who underwent SOHND (Levels I-III) between March and December 2010 were studied. Intraoperatively, sublevels IIB and IIA were dissected separately, labeled and subjected to histopathology to reveal the presence of sublevel IIB metastasis. The clinicopathological characteristics, such as perineural, perivascular and perilymphatic invasion, and tumor depth, were also recorded. Postoperatively, the patients were tested for signs of shoulder syndrome clinically.
Results: Number of nodes per patient varied from 0 to 9 and the mean value was four. Of the 101 patients, the histopathology reports of 95 patients showed reactive nodes. Only six patients (6%) demonstrated malignancy of which one presented with the perinodal spread. Postoperatively, none of the patients presented with signs of shoulder syndrome.
Conclusion: Of the total patients assessed, only 6% of the cases presented metastasis to sublevel IIB lymph nodes. Though the percentage of cases showing metastasis was very less, the benefits of preserving functions of SAN has to be weighed against possibly reduced oncological control. Since the primary goal of any cancer resection surgery is the oncological clearance and safety, sublevel IIB remains an important region to be incorporated in elective neck dissections for primary oral cavity cancers.

Background: Perforations are the one of the greatest cause of failure in endodontics. Early diagnosis of root perforations is a critical factor in treatment outcome. The aim of this study was to compare the sensitivity, specificity, and accuracy of conventional periapical (PA) radiography with cone-beam computed tomography (CBCT) in detecting strip root perforations in filled and unfilled root canals.
Methods and Materials: In this in vitro experimental study, mesial root canals of 100 extracted mandibular molar teeth were prepared. Distal wall of the mesiolingual canals were thinned by rotating a Gates Glidden. Then the mesial roots of 51 teeth were randomly perforated. All samples were examined with PA (3 horizontal angles) and CBCT before and after obturation. The images were evaluated for diagnosis of strip root perforations by two observers. Sensitivity, specificity, and accuracy of each technique for detection of strip root perforation were calculated. The data were subjected to statistical analysis using Chi-square and Fisher exact tests.
Results: In unfilled canals, sensitivity, specificity, and accuracy of the techniques for detection of strip root perforation were significantly different (P < 0.05). After obturation, PA was significantly more sensitive than CBCT (P < 0.05).
Conclusion: Under the conditions of this in vitro study, in the absence of root filling materials, CBCT was superior to PA for detection of strip root perforation but for perforation detection in obturated root canals, PA with three different horizontal angulations was more reliable.

Background: The purpose of this study was to compare and evaluate the efficacy of conventional needle irrigation delivery system, EndoActivator system, and EndoVac irrigation in removal of smear layer in root canals.
Materials and Methods: 45 freshly extracted human mandibular premolar teeth were used. The teeth were decoronated to obtain standard working length of 17 mm for all samples. Working length determination was done, and samples were instrumented up to 40 size (K-file) with 2.5% NaOCl irrigation between each instrumentation followed by irrigation with 5 ml of saline. Then, each sample was subjected to irrigation with 5 ml of 17% ethylenediaminetetraacetic acid (EDTA) using three different irrigating systems. Group I: 15 samples with 17% EDTA using conventional needle irrigation. Group II: 15 samples with 17% EDTA using EndoActivator irrigating system. Group III: 15 sample with 17% EDTA using EndoVac irrigation system. Final irrigation was done with 5 ml of Saline using a 27-gauge needle with 20 mm length. Longitudinal sectioning of the samples was done. Then, the samples were observed under scanning electron microscope at apical, middle, and coronal levels. The images were scored according to the criteria given by Torabinejad et al.: (i) 1 = No smear layer, (ii) 2 = Moderate smear layer, (iii) 3 = Heavy smear layer. Data obtained were analyzed using Kruskal-Wallis analysis of variance followed by Mann– Whitney U-test for individual comparison. The level of significance was set as 0.05.
Results: The results of the present study showed that all the irrigating systems used removed smear layer from the root canal. The EndoActivator (Group II) and EndoVac (Group III) irrigating systems had no difference among them and showed better smear layer removal at all levels of the root canal compared to conventional needle irrigation.
Conclusion: EndoActivator and EndoVac give relatively cleaner surfaces of root canal walls when used with EDTA for smear layer removal than conventional needle irrigation and probably aid in a better clinical outcome of the root canal treatment.

Background: To evaluate and compare shear bond strength of the two generations (6th generation- Clearfil SE Bond [Kuraray Co.] Osaka, Japan), (7th generation - Clearfil S3 Bond [Kuraray Co.] Osaka, Japan) of adhesive systems to non-carious surfaces of enamel and dentin in both maxillary and mandibular anterior teeth. Materials and Methods: Total 60 teeth were selected for the study. They were assigned to Group A and B of 30 teeth each. Groups A and B were then randomly divided into two subgroups of 15 teeth each. The teeth were embedded in self-curing acrylic resin block up to the cervical level, with a labial surface positioned for surface treatment. Bonding agents were used according to manufacturers' direction. All specimens were bonded with composite resin (Z-350
hybrid composite resin system. A 1 shade 3M ESPE) and subjected to shear bond strength testing, using Instron universal testing machine.
Results: Shear bond strength of Group A1 is 26.82 MPa, for Group A2 - 24.68 MPa and for Group A3 - 20.71 MPa. Shear bond strength of Group B1 is 27.09 MPa, for Group AB - 26.42 MPa and for Group B3 - 22.46 MPa. Statistical analysis was done by applying Student's unpaired t-test, one-way ANOVA analysis with post-test (Tukey-Kramer multiple comparison tests), and Fisher's exact t-test.
Conclusion: Within the limitations of this in vitro study it can be concluded that Clearfil SE Bond resulted in the higher mean shear bond strength for dentin and for enamel compared with other group.

Background: The delivery of care for orthognathic correction of Class 2 skeletal dentofacial deformities is becoming more challenging because of escalating health care costs and limited reimbursement from insurance providers. The delivery of these surgical services performed in a hospital environment under general anesthesia now can be routinely achieved in an outpatient setting of any dental office by corticotomy assisted orthodontics, substituting conventional horizontal anterior maxillary osteotomy.
Materials and Methods: A total of 20 adult patients with severe skeletal Class 2 division 1 malocclusion with mean skeletal discrepancy around A-point-nasion-B point (ANB) angle 10° and with mean occlusal discrepancies around 10 mm advised for orthognathic surgery are selected for this study. Here, investigation is done to test the efficacy of alveolar reshaping surgery and corticotomy at extraction sites under local anesthesia followed by fixed orthodontic treatment at dental office setting.
Results: The results at 3 and 6 months interval, when compared to the baseline, indicated that this treatment modality resulted in significant change in cephalometric parameters like ANB angle and overjet values with this application of treatment protocol.
Conclusion: Corticotomy assisted orthodontics comparatively a less invasive procedure than orthognathic surgery, can be utilized to improve the skeletal facial profile completely at dental office setting instead of utilizing surgical services at hospital environment under
general anesthesia.

Background: Bone grafts are necessary for the correction of many oral and maxillofacial bony defects. The deficiencies of autogenous grafts and allogenic banked bone have led to the search for synthetic alloplast alternatives. Natural coral porous calcium carbonate appears to be a clinically useful bone replacement graft material that gives essentially similar or slightly better responses in osseous defects than other bone replacement graft materials. This material appears to be safe and clinically effective for treating various osseous defects. The calcium carbonate skeleton of marine corals fulfills all requirements of an ideal bone substitute in a surgical fields.
Materials and Methods: This study is performed to evaluate the ease of preparing a potential alloplastic bone substitute and its use of different bone grafting procedures. The study includes the use of coral graft after cyst enucleation, correction of periodontal bone loss and as onlay graft for orthognathic augmentation, and as interpositional graft in preprosthetic surgery. Their biocompatibility and behavior in these three types of procedures were clinically and radiologically evaluated in intervals of 2-week for a minimum of 8 weeks.
Results: In the cases which coral were used for filling bony defects, as granules the results were commendable. Natural coral skeleton, which was used in defects after cyst enucleation, extracted sockets
and in periodontal defects showed very good results. There was no loss in the volume of the graft material nor was there any exposure of the graft material. The corals were tolerated well, and the wound healing was uneventful. This shows that natural coral skeleton is a biocompatible bone graft substitute.
Conclusion: The results of our study show that natural coral skeleton is a potential bone graft substitute when used as a bone filler. As an onlay graft where coral was used for chin augmentation, good results were seen.

Background: Dentine hypersensitivity is a common clinical condition in patients after periodontal surgery. Laser has been reported to be a better treatment option for this condition than conventional desensitizing agents. The aim of the present study is to evaluate the efficacy of 810 nm diode laser (DL) in reduction of dentine hypersensitivity (DH) in periodontal patients following surgical therapy.
Materials and Methods: Patients with chronic generalized periodontitis who underwent flap surgery and consequently experienced dentin hypersensitivity were randomly selected for the study and divided into 2 groups. Group 1(control group) patients were instructed to use Fluoride containing tooth paste. In Group 2 (test group) patients application of diode laser in non contact mode was carried out. DH was evaluated in all patients using evaporative stimulus (ES) and tactile stimulus (TS) immediately before and after therapy. It was also evaluated on the 2nd, 7th ,14th and 30th days post therapy.
Results: The test and control groups were found to be similar with regard to ES (p=0.648) and TS (p=1.000) at baseline. In the DH evaluation after 15 minutes, TS values had significant reduction in the test group in comparison with the control (p=0.04). Similarly, between 15 and 30 minutes, TS values in the test group showed a significant difference when compared to control (p=0.01). Also, despite the fact that patients in the test group were given a single application of laser at baseline, they experienced a continuous improvement in the measured response to ES (79%) and TS (95%) which lasted for up to 14 days (p=0.002). The difference from baseline through to the end of the study (day 30) for the measured parameters was found
to be significantly better for test as compared to control group (p= 0.006 for ES, p= 0.004 for TS). Conclusion: A significant immediate response was observed with DL which was maintained until day 30. Thus DL can be considered to be a useful adjunct in reducing DH post periodontal surgery.

Background: Prevention and management of post-operative endodontic pain is an integral part of endodontic treatment as it increases the patient's comfort, confidence, and improves the outcome of the endodontic therapy.
Materials and Methods: A total of 75 patients were included in the study. Their consent was taken, and 200 mg of ibuprofen, 20 mg of tenoxicam, or 10 mg of ketorolac before root canal treatment was given orally. Visual analogue scale was used to measure postoperative pain. The pain was measured at intervals of 0, 6, 12, 24, 48, and 72 h after treatment was started.
Results: All the three drugs reduced the post-treatment pain to approximately similar levels at different time lags other than 6 h interval.
Conclusion: The three drugs were approximately equally effective in controlling the pain. Further research with the higher study group and more parameters is required to find out the efficacy of various analgesics.

Background: Nasal respiratory impairment has been associated with a deviant vertical craniofacial growth pattern along with various dento-alveolar malocclusions for a century. Respiratory needs are the primary determinant of the posture of the jaws, tongue, and head. Therefore, it seems entirely reasonable that an altered respiratory pattern such as breathing through the mouth rather than the nose could change the posture. This in turn could rather alter the equilibrium of pressure on the cranium, jaws and teeth position, which might lead to various malocclusions. The objective of the present study was to radiographically measure the nature and the extent of the postural reflexive behavior of cranium, tongue, mandible, hyoid bone, and lips after total nasal obstruction.
Materials and Methods: A total of 25 nasal breathing adults were radiographically examined before and after their nasal respiratory pattern had been artificially eliminated for a period of 1-h, radiographs were taken in natural head position. Six angular and six linear variables were measured to determine the extent of the postural reflexive behavior of the cranium, mandible, hyoid bone, tongue, and lips.
Results: All subjects coped in their own individual way with the environmental impact. The most generalized findings were parting of the lips (P < 0.001), a drop in mandibular position (P < 0.001), downward movement of the hyoid bone (P < 0.05), downward movement of tongue (P < 0.001), cranial extension, and craniocervical extension were statistically highly significant (P = 0.001). The relevance of these findings relative to primate experiments and human clinical research is discussed.
Conclusion: If the same postural reactions are maintained over a long-term period, they may be instrumental in influencing the vertical craniofacial growth pattern.

Background: The aim of this study is to identify the incidence, risk factors and to evaluate the management of dry socket in South Chennai population.
Materials and Methods: This study was performed in a private dental center in Chennai, Tamil Nadu, India. A retrospective study of 1013 patients who underwent extraction of their tooth/teeth for various reasons from January 2012 to December 2013 was done.All types of extractions, excluding deciduous teeth extraction, were included in this study.
Results: Out of 1341 extractions, 72 (5.37%) extractions were complicated by a dry socket in which 44 (7.86%) were in females, and 28 (6.18%) were in males. The dry socket was more common in mandibular third molars (9.4%).
Conclusion: From the results of this study, the incidence of dry socket was 5.37% in South Chennai population. The incidence of dry socket was higher in females than in males, and it was commonly seen after the extraction of mandibular third molars.

Background: The purpose of this study was to evaluate and compare the efficacy of Pro-taper Universal Rotary re-treatment system; H-file and K-flex file in removing gutta-percha (GP) from root canal during re-treatment.
Materials and Methods: A total of 54 permanent single-rooted maxillary and mandibular premolars enlarged up to master apical file size 30 and obturated with GP and AH-Plus sealer. Teeth were randomly divided into three groups (n = 18). Re-treatment was carried out using three techniques. Group A: Pro-taper Universal Rotary re-treatment system followed by Pro-taper finishing files, Group B: H-files followed by Pro-taper finishing files, and Group C:H-files followed by K-flex files. Stereomicroscopic images of the area of root canal filling were assessed and evaluated in mm2 using an image analyzer software. Data were analyzed statistically using one-way analysis of variance and Newman– Keuls multiple post-hoc procedure.
Results: Remaining filling material was observed in all specimens. However, Pro-taper was significantly more effective than H-files and K-flex files.
Conclusion: All techniques left GP/sealer remnants within the root canal. Pro-taper Universal Rotary re-treatment system proved to be an efficient method of removing GP/sealer from the root canal and resulted in a smaller percentage of canal area covered with GP/sealer when compared with H-files and K-flex files.

Background: Literature states that no two palates are alike in their configuration and that the palatal print did not change with time or age. This unique property makes them ideal for the purpose of personal identification.
Materials and Methods: 82 patients (ages 16-25) were included in the study (40 males and 42 females). Casts were prepared from each individual impression, and the rugae length was measured
using Vernier calipers. The arch length was analyzed with the help of brass wire. The results obtained were then statistically analyzed using SPSS software version 16.0.
Results: The mean length of the rugae was found to be 12.5732 mm(standard deviation [SD] = 1.90374), and the mean arch length was found to be 79.5427 mm (SD = 5.17544). The mean rugae
length in males was found to be 13.05 mm (SD = 2.13277) and in females was 12.1190 mm (SD = 1.54923) showing no significant difference. The arch length in males (mean = 81.1 mm) and females (mean = 78.0595) failed to demonstrate any significant variation.
Conclusion: There was no significant statistical difference between both sexes in relation to the rugae pattern although there was a predominance of the curved pattern in males and straight in females. Even though the length of the rugae and arch length was slightly greater in males, the results were not statistically significant.

Pyostomatitis Vegetans in Ulcerative Colitis; Management with Topical Tacrolimus and Systemic Azathioprine in a 10-year-old Boy (Case Report and Review of the Literature)

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Nakita knapp, Z Khan, R Albuquerque, A Richards, RM Brown

Pyostomatitis vegetans (PV) is a rare disorder of the oral mucosa and the most common presents as multiple pustules. It is notoriously difficult to treat. It is consistently associated with inflammatory bowel disease and is consequently considered a highly specific marker. This report presents the case of a 10-yearold
boy diagnosed with PV, in whom complete remission of the oral lesions was eventually achieved with topical tacrolimus.

A flabby edentulous ridge decreases the stability of complete denture prosthesis. Displacement and compression of the flabby ridge result in trauma to the soft tissue and cause soreness in that region. Failure
to recognize the cardinal importance of the tooth position will result unsatisfactory outcome. The many impression techniques have been proposed to overcome this difficulty, and they vary in their approach and their complexity. This article describes three clinical cases of severely resorbed maxillary and mandibular ridges using modified William H Filler technique, selective displacement technique, and modified silicone technique.

Condensing osteitis refers to a focal area of increased radiodensity that is characterized by bone growth which is caused by mild infection of the root canal. Radiologically, it presents as a well- defined, rounded or triangular radiodensity that is uniformly opaque. Condensing osteitis appears to be most often associated with mandibular posterior teeth. Root resorption and tooth movement are rare. We present a rare case of condensing osteitis which was associated with the maxillary tooth and caused resorption of the adjacent root.

Drifting of teeth to the edentulous area may reduce the available pontic space, whereas existing diastemata before an extraction may result in excessive mesiodistal dimension for the pontic. If implant treatment is not a feasible option, loop connector fixed partial denture (FPD) may be the simplest and best solution to maintain the diastemata and provide optimum restoration of aesthetics. A systematic approach is required to resolve esthetic problems predictably. Conventional fixed dental prosthesis can surrender to esthetic failure, which makes the clinician consider treatment options. Implants may not be aﬄuent considering the economical factor, conceding to FPDs for rehabilitation. In the case report, loop connectors have been employed to project the spacing along with post-surgical gingival recontouring using the positive pressure technique to enhance the aesthetics. Anterior esthetic replacement with the loop connectors helps to maintain the diastemata with good aesthetic results. The patient was satisfied with the final outcome as the restoration achieved excellent form.

Human cathelicidins (LL-37) are an exceptional class of host defense peptides which are small, cationic, and amphipathic in nature with pleiotropic functions such as antimicrobial, chemotactic, and immunomodulatory functions. This peptide is synthesized as pre-propeptide with a signal peptide, an N-terminal cathelin domain (13.5 kDa) connected to a highly variable antimicrobial domain at C (carboxyl) terminal (4.5 kDa). These proteolytically activated peptides form a part of innate immunity functions as the first line of host defense against numerous microorganisms and join hands with other innate defenders to combat bacterial attack and colonization. In addition to antimicrobial activity, LL-37 also participates in the activation of specific immune responses in the host. Many in vitro and in vivo studies have shed the light into the pivotal role played by LL-37 in maintaining the health of the periodontium. Apart from antimicrobial activity, LL-37 exerts its protective effects on the periodontium by its antibiofilm activities, neutralizing the lipopolysaccharide of periodontal pathogens, antiosteoclast properties, and immunomodulatory effects such as neutrophil chemotaxis. LL-37 with the magnificent properties certainly takes part in curtailing the periodontal pathogens and restraining the progression of periodontitis. Studies on patients who lack LL-37 have demonstrated the occurrence of aggressive forms of periodontitis. This points to the fact that these patients are deprived of the protective functions of LL-37. Accordingly, LL-37 is an antimicrobial peptide that plays a vital role in keeping the microbial challenges (especially of the periodontal pathogens) at bay thereby functioning as elemental molecules of innate immunity in periodontal disease. This review provides an insight into the antibiofilm, anti-endotoxin, and antibacterial effects of LL-37 on periodontal pathogens.